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Addresses key challenges: incompatible social circumstances, markedly inferior and complex health status including non-medical factors, and lack of group-specific data on utilization, cost, and outcomes. Outlines 19 quality and access issues framed by promoting access to appropriate services and ensuring payment methods and information systems support quality delivery for special needs populations.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/can-managed-carework-for-homeless-people-guidance-for-state-medicaid-programs-prepared-by-care-for-the-homeless/322623/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/can-managed-carework-for-homeless-people-guidance-for-state-medicaid-programs-prepared-by-care-for-the-homeless/322623.png","ImageObject",300,407,{"name":92,"@type":93},"Liam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is integrating homeless people into state Medicaid managed care challenging?","Question",{"text":112,"@type":113},"Homeless people’s social circumstances often conflict with tightly controlled managed care access. Their health status is frequently poorer and more complex, and non-medical factors may not be addressed by managed care entities. Group-level utilization, cost, and outcome data are also insufficient.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What are the two central themes guiding the recommendations?",{"text":117,"@type":113},"The guide highlights: (1) promoting access to an appropriate range of services and (2) assuring that payment methods and information systems support quality health care delivery systems.",{"name":119,"@type":110,"acceptedAnswer":120},"What steps does the document recommend to promote access to services for the homeless population?",{"text":121,"@type":113},"It recommends that outreach and education precede enrollment and be part of marketing and enrollment; that auto-assigned enrollees go to plans with providers experienced in serving homeless people; and that MCEs create linkages with homeless health care providers offering culturally appropriate services accessible through sites such as soup kitchens, drop-in centers, and 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Care for the Homeless CouncilSSA DOCSRA564.9H63W861998  \n# CAN MANAGED CAREWORK FORHOMELESS PEOPLE\n\nGUIDANCE FORSTATE MEDICAID PROGRAMS  \nPrepared byCare for the Homeless,New York City  \nIn collaboration withNational Health Care for the Homeless Council  \nPreparation of this document was supported by a grant from theUnited States Department of Health and Human Services,HealthResources and Services Administration,Bureau of Primary HealthCare,Division of Programs for Special Populations.  \nPrepared by:David Wunsch  \nCare for the Homeless12 West 21st St.,8th FloorNew York,NY 10010-6902  \n(212)366-4459 phone  \n(212)366-1773 fax  \ne-mail:dwunsch@cfhnyc.org  \nIn collaboration with:  \nNational Health Care for the Homeless CouncilP.O.Box 60427Nashville,TN 37206-8019  \n(615)226-2292 phone(615)226-1656 fax  \ne-mail:hch@nashville.nethttp://www.nashville.net/～hch  \n# TABLE OF CONTENTS\n\n## EXECUTIVE SUMMARYPREFACE\n\n≤:\u003C  \n## ACKNOWLEDGEMENTS\n\n1  \n## INTRODUCTION\n\n### 1.THE ENVIRONMENT\n\n5  \n2.PURCHASING STRATEGIES9  \n3.ACCESS AND QUALITY13  \n4.EVALUATION AND REPORTING21  \n5.BENEFITS AND THE DELIVERY SYSTEM25  \n6.FINANCE33CONTRIBUTORS35  \n##   EXECUTIVE SUMMARY  \n\nAs MANAGED CARE BECOMES the“preferred”mechanismfor organizing and delivering health care,homeless peopleare increasingly included among the enrollees in stateMedicaid managed care programs.Their participation inmanaged care is challenging for several reasons:  \nThe social circumstances of homeless people areoften not compatible with the tightly controlledaccess to health care that characterizes managedcare.  \nThe health status of many homeless people ismarkedly inferior to that of traditional managedcare enrollees,and is characterized by complex,interrelated conditions,including non-medicalfactors not usually addressed by managed careentities(MCEs).  \nData on health care utilization,cost and outcomeshave not been collected and analyzed for homelesspeople as a group,undermining the ability of statesto effectively integrate them into managed carearrangements.  \nHomeless people are a special needs population that share:  \nidentifiable social characteristics(chiefly their lackof housing)which distinguish them as a group anddiminish their ability to access health care services;and  \nextremely poor health status which threatens theirindividual functioning,and/or the public health,  \n1  \nwhile at the same time posing significant avoidablepublic costs for deferred treatment.  \nHomeless people are not alone in meeting this definition ofa special needs population.To assure that the health careneeds of all special needs populations are addressed inmanaged care delivery systems,it is critical that thesepopulations be identified,particularly where Medicaid orother public funding is involved.  \nThis document presents nineteen quality and access issuesspecific to the special needs of homeless people in amanaged care environment.State officials,MCEs,healthcare providers,advocates and consumers should considerthese issues as critical factors as they develop andimplement managed care programs for the Medicaidpopulation.For convenience,these critical factors areorganized using the framework outlined in KEYAPPROACHES TO THE USE OF MANAGED CARESYSTEMS FOR PERSONS WITH SPECIAL HEALTHCARE NEEDS.This Health Care FinancingAdministration (HCFA)draft document recommends someinitial steps that states can take in developing a managedhealth care system that meets the needs of specialpopulations.In doing this,KEYAPPROACHES highlightstwo major themes that are central to the 19 critical factorsfor homeless people enrolled in managed care and that areaddressed in this guide:1)promoting access to anappropriate range of services;and 2)assuring thatpayment methods and information systems support qualityhealth care delivery systems.  \n### 1.Promoting ac","cbCaidhgmLNi8QHH","https://ap.wps.com/l/cbCaidhgmLNi8QHH","pdf",1324182,52,"English","# EXECUTIVE SUMMARY\n## PREFACE\n## ACKNOWLEDGEMENTS\n# INTRODUCTION\n## 1. THE ENVIRONMENT\n## 2. PURCHASING STRATEGIES\n## 3. ACCESS AND QUALITY\n## 4. EVALUATION AND REPORTING\n## 5. BENEFITS AND THE DELIVERY SYSTEM\n## 6. FINANCE\n# EXECUTIVE SUMMARY\n## 1. Promoting access to an appropriate range of services\n## 2. Assuring payment methods and information systems to support quality health care delivery systems","[{\"question\":\"Why is integrating homeless people into state Medicaid managed care challenging?\",\"answer\":\"Homeless people’s social circumstances often conflict with tightly controlled managed care access. Their health status is frequently poorer and more complex, and non-medical factors may not be addressed by managed care entities. Group-level utilization, cost, and outcome data are also insufficient.\"},{\"question\":\"What are the two central themes guiding the recommendations?\",\"answer\":\"The guide highlights: (1) promoting access to an appropriate range of services and (2) assuring that payment methods and information systems support quality health care delivery systems.\"},{\"question\":\"What steps does the document recommend to promote access to services for the homeless population?\",\"answer\":\"It recommends that outreach and education precede enrollment and be part of marketing and enrollment; that auto-assigned enrollees go to plans with providers experienced in serving homeless people; and that MCEs create linkages with homeless health care providers offering culturally appropriate services accessible through sites such as soup kitchens, drop-in centers, and shelters.\"}]","CAN MANAGED CAREWORK FOR HOMELESS PEOPLE - Guidance for State Medicaid Programs - Prepared by Care for the Homeless | PDF",1789963149,131]